Acute bacterial prostatitis is an acute focal or diffuse suppurative inflammation of the prostate gland.
Acute prostatitis is a bacterial infection needing prompt treatment with antibiotics.
Gram-negative bacteria are the most common causative pathogens in acute prostatitis, most commonly (1)
- Escherichia coli,
- Proteus species,
- Klebsiella species and
- Pseudomonas species
The prostate is usually involved as a consequence of:
- direct extension from the posterior urethra or urinary bladder
- distant spread in the blood or lymphatics
Occasionally, infection may spread from the rectum.
Complications of acute prostatitis include:
- acute urinary retention secondary to prostatic oedema,
- chronic prostatitis,
- prostatic abscess,
- epididymitis and
- in England, resistance of E. coli (the main causative organism of acute
prostatitis) in laboratory processed urine specimens to the following antibiotics
- ciprofloxacin: 10.6% (varies by area from 7.8% to 13.7%)
- trimethoprim: 30.3% (varies by area from 27.1% to 33.4%) (Public Health England. Antimicrobial resistance quarterly surveillance: March 2018)
- Public Health England (October 2014). Management of infection guidance for primary care for consultation and local adaptation
- NICE (October 2018).Prostatitis (acute): antimicrobial prescribing